“My sciatica is acting up.” That’s how many people describe the sharp, burning or tingling sensations they experience in their lower back and buttocks that comes and goes. In some cases, sufferers feel gripping pain right down to the tips of their toes.
Sciatica is actually a symptom caused by a disorder in the lumbar (lower) spine, near the sciatic nerves. Sciatica describes the pain that occurs when these thick nerves become pinched or compressed.
The pain’s location depends on which portion of the nerve is affected. That covers a lot of territory, since the sciatic nerves are the largest in the body—stretching from the spinal cord to the feet.
Sciatica usually occurs on only one side of the body. But that’s little consolation when it hurts to move even slightly or to remain sitting or standing for too long. Even coughing, sneezing or laughing may cause pain.
Flare-ups can happen seemingly out of nowhere. Sometimes they last for a month or two and are gone for good. Other times, people suffer from chronic bouts of sciatica until they find the right remedy.
Herniated, or slipped, disks (the cartilage-like cushions between the spaces of the vertebrae in the back) are the most common cause of sciatica. These spinal “shock absorbers” allow the back to turn and bend easily.
An accident, a fall or an injury can cause cracks in the outer layers of the disks, causing the central cushion to bulge out of place. This puts pressure on the spinal cord or the nerves that branch out from it, including the sciatic nerve.
In the past, physicians recommended bed rest. But newer research suggests that staying active is just as good as a prescription.
Of course, if you have sciatica, this is not the time to take up a new sport. Being active means moving around but not intensely enough to exacerbate the pain. An ideal way to achieve this is with physical therapy. Supervised exercises and medical treatments can relieve pain, increase mobility and build strength and endurance to prevent future flare-ups. Physical therapy programs are highly personalized and may include massage, ice therapy or ultrasound heat treatments.
Doctors may prescribe medications ranging from simple aspirin and muscle relaxants to anti-inflammatory drugs, or NSAIDs, which reduce swelling around the nerves. For longer-lasting relief, doctors may use an epidural, or a cortisone-like drug injected into the spine region. Acupuncture is also an alternative treatment.
With proper care, many people suffering from sciatica feel better within a month or two. However, sometimes surgery is needed to permanently relieve pressure on the affected nerve tissue or to correct problems that hinder bowel and bladder function.
To safeguard against sciatica, consider making simple changes in your daily routine. Protect your back by always lifting objects from a bent-knee position while using your leg muscles to stand up. Avoid staying in any one standing or sitting position for too long. And maintain good posture to help relieve pressure on the lower back.
Talk with your doctor about starting an exercise program. Walking, swimming and yoga can strengthen the abdominal muscles that support the spine and back, giving you added protection from injury.
If you think you may have sciatica, see your doctor to pinpoint the root of the problem.